Individual
TESSA PENN-SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
310 W ELM ST, DEMING, NM 88030-4123
(575) 546-5951
Mailing address
1001 S DIAMOND AVE, DEMING, NM 88030-4710
(575) 546-0427
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-5332
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C-5332
SLP CLINICAL FELLOW
NM
Enumeration date
09/25/2013
Last updated
09/25/2013
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